Background: The Narcotrend (Monitor Technik, Bad Bramstedt, Germany) assesses sedation by automatic classification of EEG signals, using a scale first used for visual evaluation of the EEG. Limited information is available on its value, and only a few studies of the method exist. We set out to study the performance of the Narcotrend during propofol sedation.
Methods: In 23 ASA I-II patients, aged 18-65 yr, about to have general anaesthesia, we induced anaesthesia in steps using a target-controlled infusion of propofol. After equilibration for 8 min at each predicted propofol concentration (0.5, 1.0, 2.0, 3.0 and 4.0 microg x ml(-1)), sedation was assessed clinically with the modified Observer's Assessment of Alertness/Sedation Scale and the Narcotrend stage was noted. The prediction performance of the Narcotrend was assessed with the prediction probability P(K). A P(K) value of 1.0 means an exact prediction on every occasion, while a P(K) of 0.5 is no better than a 50:50 chance of being correct.
Results: In 12 women and 11 men (age 42 (sd 11) yr), a total of 138 measurements were made; 129 were analysed and nine were of poor signal quality. The prediction probability for the corresponding level of sedation was P(K)=0.92 (se 0.01); for the different target concentrations of propofol it was P(K) = 0.91 (se 0.01).
Conclusions: The Narcotrend can monitor sedation with propofol. Other sedatives, anaesthetics and opioids should be used to test this monitor.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/bja/aeh142 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring.
Neuroimage
December 2024
Department of Anesthesiology and Intensive Care Medicine, Technical University of Munich, School of Medicine and Health, 81675 Munich, Germany.
Background: Cortical high-frequency activation immediately before death has been reported, raising questions about an enhanced conscious state at this critical time. Here, we analyzed an electroencephalogram (EEG) from a comatose patient during the dying process with a standard bedside monitor and spectral parameterization techniques.
Methods: We report neurophysiologic features of a dying patient without major cortical injury.
Intraoperative Burst Suppression by Analysis of Raw Electroencephalogram Postoperative Delirium in Older Adults Undergoing Spine Surgery: A Retrospective Cohort Study.
J Neurosurg Anesthesiol
November 2024
Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA.
Background: Postoperative delirium is a common complication in older adults, associated with poor outcomes, morbidity, mortality, and higher health care costs. Older age is a strong predictor of delirium. Intraoperative burst suppression on the electroencephalogram (EEG) has also been linked to postoperative delirium and poor neurocognitive outcomes.
View Article and Find Full Text PDFDetermining the optimum dose of remifentanil in combination with propofol for total intravenous anaesthesia in hysteroscopy under Narcotrend and SPI monitoring.
Ther Adv Drug Saf
November 2024
Department of Anesthesiology, International Peace Maternity & Child Health Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200030, China.
Background: Outpatient hysteroscopic surgery requires patients to be anaesthetised and recover quickly, and the drugs used must be safe and effective. Remifentanil is typically co-administered with propofol as total intravenous anaesthesia (TIVA) for hysteroscopy because of its favourable pharmacokinetic and pharmacodynamic properties. However, the optimal dose of remifentanil when co-administered with propofol without neuromuscular blocking agents (NMBAs) has not been established.
View Article and Find Full Text PDFValue of narcotrend anesthesia depth monitoring in predicting POCD in gastrointestinal tumor anesthesia block patients.
BMC Anesthesiol
October 2024
Department of Gastrointestinal Surgery, The First Hospital of Xingtai, No. 376, Shunde Road, Xiangdu District, Xingtai, 054000, China.
Background: The purpose of this research was to evaluate the efficacy of Narcotrend (NT) monitoring on cognitive dysfunction in patients undergoing anesthesia blockade for gastrointestinal tumors and its effect on cerebral oxygen metabolism and inflammatory response.
Methods: Patients preparing to undergo resection of gastrointestinal tumor resection were included and randomly divided into a control group (depth of anesthesia assessed by physician experience) and a research group (depth of anesthesia monitored by NT). HR and MAP were monitored at the preoperatively (T), 12 h postoperative (T), 24 h postoperative (T), and 48 h postoperative (T) stages.
Relationships between the qNOX, qCON, burst suppression ratio, and muscle activity index of the CONOX monitor during total intravenous anesthesia: a pilot study.
J Clin Monit Comput
December 2024
Department of Anesthesiology and Intensive Care, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Article Synopsis
- The study investigates how different processed EEG indices, specifically qCON (hypnotic level) and qNOX (nociception), interact during propofol anesthesia in patients.
- It finds strong linear relationships among qCON, qNOX, EMG activity, and burst suppression, indicating that these indices can help differentiate the hypnotic and pain-relief aspects of anesthesia.
- A key conclusion is that high qCON levels depend on EMG activity, highlighting potential challenges in detecting wakefulness without EMG, and noting that high opioid doses may affect the relationship between qCON and qNOX.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!